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"Lester, Matthew"
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A do-it-yourself 3D-printed thoracic spine model for anesthesia resident simulation
Central line placement, cricothyroidotomy, and lumbar epidural placement are common procedures for which there are simulators to help trainees learn the procedures. However, a model or a simulator for thoracic epidurals is not commonly used by anesthesia training programs to help teach the procedure. This brief technical report aims to share the design and fabrication process of a low-cost and do-it-yourself (DIY) 3D-printed thoracic spine model. Ten expert anesthesiology attendings and fifteen novice anesthesiology residents practiced with the model and were subsequently surveyed to assess their attitudes towards its fidelity and usefulness as a teaching tool. Responses were recorded with a Likert scale and found to be positive for both groups. Design files and an assembly manual were developed and made public through an open-source website.
Journal Article
التواصل الفعال مع الأزمات : الانتقال من الأزمة إلى الفرصة
يعمل هذا الكتاب على تزويد المسئولين بالمؤسسات بالمزيد من خيارات الاستجابة للأزمات رغم وجود خيار الحفاظ على سمعة تلك المؤسسات، وتميز هذا الكتاب بعدة خصائص عن غيره من الكتب التي طرحت فكرة الاستجابة للأزمة من قبل رغم أن كل الأزمات تنطوي على مستوى معين من الخطورة والتهديد، إلا أن مؤلفي هذا الكتاب يبذلون جهدا شاقا من أجل إثبات أن الأزمات يمكن أن تتحول إلى فرص للتجديد والتطوير والتنمية، كما أنهم يعرضون على صفحات الكتاب الدروس المستفادة من الأزمات، والمخاطر، والتهديدات التي يمكن أن تتوفر لنا لنتعلم مما حدث، ولننقل المعلومات بصدق، وبصورة أخلاقية؛ للعمل على الحد من الأضرار التي لحقت بالمؤسسات التي تأثرت بصورة مباشرة بالأزمة، كما يبتكر المؤلفون رؤية مستقبلية يتمكن من خلالها المسئولون بالمؤسسات من السير قدما.
BOOK
Geographic factors as determinants of food security: A Western Australian food pricing and quality study
Food affordability and quality can influence food choice. This research explores the impact of geographic factors on food pricing and quality in Western Australia (WA). A Healthy Food Access Basket (HFAB) was cost and a visual and descriptive quality assessment of 13 commonly consumed fresh produce items was conducted in-store on a representative sample of 144 food grocery stores. The WA retail environment in 2010 had 447 grocery stores servicing 2.9 million people: 38% of stores the two major chains (Coles Supermarkets Australia and Woolworths Limited) in population dense areas, 50% were smaller independently owned stores (Independent Grocers Association ) in regional areas as well, and 12% Indigenous community stores in very remote areas. The HFAB cost 24% (p<0.0001) more in very remote areas than the major city with fruit (32%, p<0.0001), vegetables (26.1%, p<0.0005) and dairy (40%, p<0.0001) higher. Higher price did not correlate with higher quality with only 80% of very remote stores meeting all criteria for fresh produce compared with 93% in Perth. About 30% of very remote stores did not meet quality criteria for bananas, green beans, lettuce, and tomatoes. With increasing geographic isolation, most foods cost more and the quality of fresh produce was lower. Food affordability and quality may deter healthier food choice in geographically isolated communities. Improving affordability and quality of nutritious foods in remote communities may positively impact food choices, improve food security and prevent diet-sensitive chronic disease. Policy makers should consider influencing agriculture, trade, commerce, transport, freight, and modifying local food economies.
Journal Article
Understanding food security issues in remote Western Australian Indigenous communities
Issue addressed: Food insecurity in remote Western Australian (WA) Indigenous communities. This study explored remote community store managers' views on issues related to improving food security in order to inform health policy. Method: A census of all remote WA Indigenous community store managers was conducted in 2010. Telephone interviews sought managers' perceptions of community food insecurity, problems with their store, and potential policy options for improving the supply, accessibility, affordability and consumption of nutritious foods. Descriptive analyses were conducted using SPSS for Windows version 17.0. Results: Managers stated that freight costs and irregular deliveries contributed to high prices and a limited range of foods. Poor store infrastructure, compromised cold chain logistics, and commonly occurring power outages affected food quality. Half of the managers said there was hunger in their community because people did not have enough money to buy food. The role of nutritionists beyond a clinical and educational role was not understood. Conclusions: Food security interventions in remote communities need to take into consideration issues such as freight costs, transport and low demand for nutritious foods. Store managers provide important local knowledge regarding the development and implementation of food security interventions. So what? Agencies acting to address the issue of food insecurity in remote WA Indigenous communities should heed the advice of community store managers that high food prices, poor quality and limited availability are mainly due to transport inefficiencies and freight costs. Improving healthy food affordability in communities where high unemployment and low household income abound is fundamental to improving food security, yet presents a significant challenge.
Journal Article
Understanding food security issues in remote Western Australian Indigenous communities
Issue addressed: Food insecurity in remote Western Australian (WA) Indigenous communities. This study explored remote community store managers' views on issues related to improving food security in order to inform health policy. Method: A census of all remote WA Indigenous community store managers was conducted in 2010. Telephone interviews sought managers' perceptions of community food insecurity, problems with their store, and potential policy options for improving the supply, accessibility, affordability and consumption of nutritious foods. Descriptive analyses were conducted using SPSS for Windows version 17.0. Results: Managers stated that freight costs and irregular deliveries contributed to high prices and a limited range of foods. Poor store infrastructure, compromised cold chain logistics, and commonly occurring power outages affected food quality. Half of the managers said there was hunger in their community because people did not have enough money to buy food. The role of nutritionists beyond a clinical and educational role was not understood. Conclusions: Food security interventions in remote communities need to take into consideration issues such as freight costs, transport and low demand for nutritious foods. Store managers provide important local knowledge regarding the development and implementation of food security interventions. So what? Agencies acting to address the issue of food insecurity in remote WA Indigenous communities should heed the advice of community store managers that high food prices, poor quality and limited availability are mainly due to transport inefficiencies and freight costs. Improving healthy food affordability in communities where high unemployment and low household income abound is fundamental to improving food security, yet presents a significant challenge.
Journal Article
From The Ground Up: Expert Perceptions of Lower Limb Activity Monitoring in Tennis
Understanding on-court movement in tennis allows for enhanced preparation strategies to improve player readiness and performance. Here, we explore expert physical preparation coaches’ perceptions of elite training strategies for preparation and performance in tennis, with special reference to lower limb activity. Thirteen world renowned tennis strength and conditioning coaches were interviewed in a semi-structured method that explored four key topic areas of physical preparation for tennis: i) the physical demands; ii) load monitoring practice; iii) the direction of ground reaction forces application during match-play; and iv) the application of strength and conditioning for tennis. Three higher-order themes emerged from these discussions: i) off-court training for tennis should be specific to the demands of the sport, ii) the mechanical understanding of tennis lags our physiological approach, and iii) our understanding of the lower limb’s contribution to tennis performance is limited. These findings provide valuable insights into the importance of improving our knowledge relevant to the mechanical demands of tennis movement, whilst highlighting important practical considerations from leading tennis conditioning experts.
Journal Article
Vaccine coverage, timeliness and delay estimated from regional and national cross-sectional surveys in Ethiopia, 2016
measures of vaccine timing require data on vaccination dates, which may be unavailable. This study compares estimates of vaccine coverage and timing; and compares regression techniques that model these measures in the presence of incomplete data.
this cross-sectional study used the 2016 Ethiopian Demographic and Health Survey (DHS), and a 2016 survey from Worabe, Ethiopia. Three measures of vaccine uptake were calculated: coverage (regardless of timing), timeliness (within 1 week of recommended administration), and delay (the number of days between the recommended and actual date of vaccination). Vaccine coverage and timeliness were modeled with logistic regressions. After excluding those without dates, vaccine delay was estimated using linear regression or survival analysis. Vaccine delay was also estimated using accelerated failure time (AFT) models.
the DHS survey included 3819 children aged 12-60 months and the Worabe survey included 484 children aged 12-23 months. In the Worabe survey, vaccine coverage for pentavalent vaccine dose 3 was 87.4%, with 8.6% receiving it within 1 week, and 71.7% within 4 weeks; the median delay was 19 days. Predictors of outcomes were similar in both the Worabe survey and Ethiopian DHS, with the largest numbers of significant associations seen in models with vaccine coverage or delays (with AFT models) as the outcomes.
estimates of coverage may miss a substantial proportion of infants who have delayed vaccination. Accelerated failure time (AFT) models are useful to estimate vaccine delay because they include information from all respondents (those with full and partial data on vaccination dates) and are agnostic about an age limit for timely vaccination.
Journal Article
The Contribution of Geogenic Particulate Matter to Lung Disease in Indigenous Children
Indigenous children have much higher rates of ear and lung disease than non-Indigenous children, which may be related to exposure to high levels of geogenic (earth-derived) particulate matter (PM). The aim of this study was to assess the relationship between dust levels and health in Indigenous children in Western Australia (W.A.). Data were from a population-based sample of 1077 Indigenous children living in 66 remote communities of W.A. (>2,000,000 km2), with information on health outcomes derived from carer reports and hospitalisation records. Associations between dust levels and health outcomes were assessed by multivariate logistic regression in a multi-level framework. We assessed the effect of exposure to community sampled PM on epithelial cell (NuLi-1) responses to non-typeable Haemophilus influenzae (NTHi) in vitro. High dust levels were associated with increased odds of hospitalisation for upper (OR 1.77 95% CI [1.02–3.06]) and lower (OR 1.99 95% CI [1.08–3.68]) respiratory tract infections and ear disease (OR 3.06 95% CI [1.20–7.80]). Exposure to PM enhanced NTHi adhesion and invasion of epithelial cells and impaired IL-8 production. Exposure to geogenic PM may be contributing to the poor respiratory health of disadvantaged communities in arid environments where geogenic PM levels are high.
Journal Article